Sexuality in Later Life

bisexual symbolThe likelihood of sexual activity during later life is related to how sexually active a person was during his or her younger years. Given an available partner, a person who was sexually active in younger years is likely to remain active into late adulthood.

Men who have been sexually active generally can engage in some sort of sexual activity well into their 70s or 80s. About 90 percent of erectile problems are physical rather than psychological. To have an erection, the man must be in a responsive state of mind and have normal hormone functioning, including adequate testosterone levels and penile blood supply. Possible impediments include hypertension, elevated cholesterol, diabetes, coronary artery disease, smoking, alcohol abuse and medications (especially those used to treat hypertension and depression). Surgeries such as a radical prostatectomy also may cause erectile problems. Aging itself is not to blame.

Reports indicate that about 52 percent of men aged 40 to 70 have some degree of erectile dysfunction. About one out of four men aged 65 to 80 have serious problems achieving and sustaining erections. In the group of men older than 80, one out of two have substantial erectile problems. Sildenafil citrate (Viagra) works for more than half of men who use it. Perhaps due to humiliation, shame or the belief that there is no help, few men seek medical attention for sexual problems.

As a man enters late adulthood, it is normal for erections to occur less frequently. More stimulation is needed for arousal. The ability to have repeated ejaculations is lessened, but once achieved, an erection lasts longer. Ejaculation also can be delayed. The volume of semen remains the same, but sperm counts are lowered. This information will help the man and his partner understand normal changes.

Physiologically, women are able to be sexually active as long as they live. A woman who enjoyed sex in younger years is likely to want to continue. The problem often, however, is the lack of a partner. In 1998, 46 percent of women older than 65 were widowed while only 15 percent of men were. Women who had orgasms in their younger years will likely be able to do so well into their 80s or later. Sex, however, will be different later in life than it was during earlier periods. Orgasms tend to be shorter, and muscle contractions are fewer in number. With age, women may take longer to become sexually aroused. Decreased ovarian estrogen production following menopause is likely to create vaginal dryness, leading to painful intercourse. Older women may need information about use of lubricants to ameliorate this problem. Some aging women feel self-conscious about their appearance. As a woman ages, weight gain is common, as are changes in body shape due to redistribution of adipose tissue around the abdominal area. Counseling can provide an opportunity for discussion about feelings related to normal body changes and help a woman feel more comfortable with and knowledgeable about her physical self. Non-intercourse avenues of sexual expression can be encouraged between elder adults.

Sexual functioning in both sexes is likely to be enhanced by physical fitness. Partners who are in good physical condition are more likely to enjoy sex. They possess the energy requirements for intercourse. Pain, from conditions such as arthritis or back ailments, also can make sex less desirable.

by Michael Newman ~

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